Three-dimensional CT-fluoroscopy fusion imaging improves the efficiency of left atrial appendage occlusion: A comparative study with a real-time guidance planning system.

Real-time three-dimensional (3D) fusion of cardiac computed tomography (CT) with fluoroscopy may enhance procedural guidance in left atrial appendage closure (LAAC), yet comparative data with conventional planning systems are limited

METHODS

In this retrospective comparative study, 109 consecutive patients undergoing LAAC were assigned to guidance using either 3D CT-fluoroscopy fusion (n = 51) or the real-time operation guidance planning system (ROGPS, n = 58). Procedural efficiency, radiation exposure, contrast use, and clinical outcomes were analyzed

RESULTS

The 3D fusion group demonstrated significant reductions in contrast volume (60.2 ± 15.0 mL vs. 75.3 ± 15.0 mL, p < 0.001), fluoroscopy time (8.0 ± 3.6 min vs. 10.2 ± 3.7 min, p = 0.002), and total procedure time (62.2 ± 12.0 min vs. 68.5 ± 11.2 min, p = 0.005). Radiation dose (DAP) was also lower in the fusion group (29.8 ± 20.8 Gy·cm2 vs. 42.2 ± 27.7 Gy·cm2, p = 0.01). Procedural success was 100% in both groups. No statistically significant differences were observed in the rates of device-related thrombosis (DRT) or peri-device leakage (PDL)

CONCLUSION

3D CT-fluoroscopy fusion imaging significantly improves procedural efficiency in LAAC compared to ROGPS, reducing contrast use, radiation exposure, and procedure time without compromising safety.